Model Form for Withdrawal from the Contract
Notice of Withdrawal from the Contract
- Addressee: LEJA Collective s.r.o., ID No.: 243 84 232
Registered office: Lucni 325, Nova Role 362 25 - I hereby give notice that, pursuant to the Civil Code (Act No. 89/2012 Coll.), I am withdrawing from the
contract for the supply of these goods or services:
……………………………………………………………………………………………………………………………….. - Ordered on: …………………………………………………………………………………………………………
- Name and surname of the buyer: ……………………………………………………………………………
- Address of the buyer:
………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………….. - Order or reservation number: …………………………………………………………………………………
- The purchase price is to be returned to bank account number:
…………………………………………………………………….. / …………………… - Signature of the buyer (only if this form is sent in paper form):
…………………………………………………………………….. - Date: …………………………………………………………..